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Social Care

Volume 815: debated on Wednesday 27 October 2021


Asked by

To ask Her Majesty’s Government what proportion of the new Health and Social Care Levy will be allocated to the provision of social care.

On 7 September, we announced £5.4 billion of new funding for adult social care over the 2022 to 2025 period. We have also announced that this includes more than £3.6 billion to reform the adult social care charging system and to help local authorities better sustain their markets by moving towards paying providers a fair rate for care. It also includes more than £1.7 billion for much-needed wider system reform. Further details will be announced in a White Paper later this year.

My Lords, the Health Foundation has calculated that, over the next three years, the funding required just to meet current social care demand is bigger than the extra money going into social care from the levy. So this levy will not even start to address issues such as the need for better pay and conditions for social care staff, local government’s lack of resources, and the need for community care, personalisation, et cetera. Could the Minister explain how he expects the country to believe the Government’s plan that, after three years of operation, the NHS portion of the levy, which is currently the majority, will be cut and transferred to social care? Can he confirm that the plan is really to cut NHS funding in 2025 in the face of ever rising demands on its services?

The Government have always been clear that the share of the levy going towards the NHS to tackle the backlog was temporary and that, in the longer term, we would move to funding social care. As I am sure the noble Lord is aware, for decades, Governments have kicked the can down the road and have not tackled this difficult issue. The Government have been quite firm in committing money and have been learning, in our constant discussion with stakeholders, how best to reform the social care sector.

Can the Minister give an assessment of whether the health and social care levy will enable more people with moderate care needs to become eligible for social care funding?

I thank the right reverend Prelate for that question. I am not able to answer it directly now, but I will send an answer.

My Lords, further to the question from the right reverend Prelate, I understand the concern that the proceeds from the ring-fenced levy may not be enough to relieve all the pressure on social care. So will the Minister encourage the NHS trusts, which are receiving the bulk of the extra funds, to use Section 75 of the National Health Service Act 2006 to commission social care, thereby taking some of the pressure off local authorities?

I thank my noble friend for that suggestion, and I will take it back. What we have to remember about the way social care is funded is that, in reality, it is mostly private providers that provide social care, and these are funded by private and state-funded patients. Quite often, we find it is private patients who cross-subsidise state-funded patients. I will take the question from my noble friend back and send an answer.

My Lords, the NHS hospital system is the carer of last resort. When the community’s needs are not being met as they ought to be by social care or primary healthcare, they go into hospital. This puts excessive demand on hospital resources, which should be devoted to dealing with the elective backlog and waiting lists. Does the Minister recognise that this distortion, with its damaging effects on the NHS, can be corrected only when the NHS is partnered by a well-funded and reformed social care system?

It is quite clear that, if we want to make sure that the social care system is fit for purpose, we have to make sure that, in the model, enough money is going in to reform the system. Part of the funding does go to helping local authorities push for reform, but, at the same time, it is true that some of the additional productivity as a result of digitisation will help make the NHS more efficient.

My Lords, is it not an unfortunate fact that not a single penny from the levy will actually go to the front line of social care to relieve those overworked and underpaid staff making 15-minute visits, which is the real urgency? Even when the money does come to social care, some way down the line, will not much of it be taken up with bureaucracy, in making assessments and testing eligibility for the cap that the Government have put into the system? Surely that is something that we have to look at. How much of the money is actually going to go to the front line, not just now but in three or four years’ time.

The noble Baroness makes a very important point: we have to see reforms in the social care sector. The spending of £5.4 billion includes £1.7 billion for wider system reforms, including at least £500 million to support the adult social care workforce in professionalisation and well-being. We are also working closely with providers of care, local government charities, the unions, professional bodies, and users of care and their representatives, and will respond to their views in the forthcoming adult social care system reform White Paper, later this year.

My Lords, so far the Minister has responded only on the issue of adult social care. Freedom of information requests from every local authority in England by the Disabled Children’s Partnership reveal that 40% of authorities cut the respite care for parent carers during the pandemic. This comes as eight in 10 parent carers are experiencing some form of anxiety—a rate much higher than among the general population. Can the Minister outline specifically how the health and social care levy will help restore short breaks and respite care for families with disabled children?

The noble Baroness makes an important point that we should address. In looking at the wider picture, we recognise that unpaid carers play a vital role in our care system and make a considerable contribution to society, alongside the paid social care workforce. The Care Act encourages local authorities to support unpaid carers and provide preventive care to stop people’s early care needs escalating. The announcement of the £5.4 billion funding marks the next step in our transformational plans for the sector.

My Lords, if the care system is to improve, a critical element is that of a suitably skilled workforce. Can my noble friend tell the House what plans there are to deliver a new deal for the care workforce?

I thank my noble friend for that important point. We have listened to the sector and prioritised the adult social care workforce. The investment of at least £500 million over three years will deliver new qualifications, progression pathways, and well-being and mental health support. This workforce package is unprecedented investment, which will support the development and well-being of the care workforce. It will enable a fivefold increase in public spending on the skills and training of our care workers and registered managers, as well as on their well-being.

My Lords, the Secretary of State, Sajid Javid, has admitted that the Government cannot commit to clearing the NHS treatment backlog generated by Covid within three years. This is despite the fact that £12 billion a year raised from the levy will mostly go to fund this work and that he is also announcing another £6 billion in capital funding for the same purpose. Does this recognition of the scale of the NHS challenge mean that social care will have to wait even longer than three years for any levy funding? Can the Minister confirm, as he failed to do last week, that the £162.5 million announced for the social care workforce and recruitment fund was new money and not part of previous repackaging, as we have seen with the Chancellor’s pre-spending review announcements so far?

The funding commits us from 2022 to 2025—it is three years’ funding. The point that the noble Baroness makes is that, of course, we are hoping that we can clear as much of the elective backlog as possible. After that, the money will be moved and will focus on social care reforms. On her specific question, I will write to the noble Baroness.

My Lords, my question builds on that of the noble Lord, Lord Young of Cookham. Can the Minister explain how social care is to cope now, when there is a crisis, without a larger allocation of the levy in addition to funds announced, and, in particular, how delayed transfers of care from acute hospitals may be reduced? Should there be central guidance to the NHS to commission social care services to assist in safe rapid discharge?

In looking at how we reform the adult social care workforce, we have consulted a wide range of stakeholders, not only on what we do from 2022 to 2025 but on what we do in the short term. Further details will be announced soon.

My Lords, £1 in every £12 spent by local authorities on social care goes towards funding mental health social care, supporting people of all ages who live with severe mental illness, and their carers. Can the Minister say what proportion of the planned levy will be used to fund mental health social care, which provides such a lifeline to all those affected?

The noble Baroness makes a valuable point about the need to look at mental health and social care. The issue is that, sometimes, for some of the patients who are being helped, it is not only mental health that we are looking at; there is a multiplicity of issues. I will try to get a specific answer and will write to the noble Baroness.